Christmas tree neurogenic bladder

Case contributed by Dr Matt Skalski


Chronic difficulty emptying bladder. Recurrent urinary tract infections. Otherwise healthy.

Patient Data

Age: 20 years
Gender: Female

Retrograde cystogram showing a bladder that is markedly trabeculated and reduced in capacity. The bladder demonstrates a relative increase in vertical dimension and tapers superiorly, giving the characteristic Christmas tree bladder appearance.

The metallic vascular clips in the right lower quadrant are most likely associated with the reported history of appendectomy. 

A lipomatous lesion extends along the posterior central canal from L1/2 to L3/4. Small central areas of decreased signal are noted. The lesion is effaces and indents the cauda equina. The conus is slightly low, terminating at L2.

Small central disc protrusions are present at L3-L4 and L4-L5.

There is spina bifida occulta at L5 and S1-S3.


Diagram of a trabeculated bladder giving the appearance of a Christmas tree. Notice the similarity to the first image in this case. 

Case Discussion

This case represents a neurogenic bladder caused by a tethered cord and related sacral spina bifida occulta.

PlayAdd to Share

Case information

rID: 41884
Published: 24th Dec 2015
Last edited: 20th Dec 2019
System: Urogenital, Spine
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.